尘螨标准化变应原对儿童哮喘治疗作用临床探究.docVIP

尘螨标准化变应原对儿童哮喘治疗作用临床探究 　 作者：洪爽，曲政海，车淑玉，林荣军 【摘要】 目的：探讨特异性免疫治疗（SIT）对儿童哮喘的治疗效果和安全性。方法：对53例尘螨过敏的哮喘患儿采用尘螨标准化变应原进行SIT，通过观察不同时期激素吸入量、肺功能变化和哮喘症状评分确定SIT的效果，分析其不良反应及安全性。结果：于治疗37周开始SIT组激素吸入量较对照组明显降低（t=2.80～5.17，Plt;0.01）；治疗51周开始SIT组PEF较对照组明显提高（t=2.07～3.59，Plt;0.05），而FEV1两组比较差异无统计学意义（Pgt;0.05）；治疗第二年，SIT组临床症状评分明显提高（t=4.59～7.36，Plt;0.01）；所有患儿无严重不良事件发生。结论：采用尘螨SIT，可明显减少激素吸入剂量，改善肺功能，提高临床症状评分，安全可靠。 【关键词】 儿童；哮喘；特异性免疫治疗；标准化变应原；肺功能 ［Abstract］ Objective:To investigate the effectiveness and safety of standardized dust mite allergen specific immunotherapy in children with asthma.Methods: 53 cases were determined dust mite allergens in children with the use of dust mite allergen standardization to the specific immunotherapy.Then we observed the clinical effects, including different amount of inhaled steroid, the changes in lung function, asthma symptom score and the security in the process of injection. Results:The inhaled steroid dose reduced gradually in children with asthma, and after 37 weeks the inhaled steroid dose of SIT group was lower than that of the control group (t=2.80～5.17, Plt;0.01), lung function gradually improved, 51 weeks after the treatment, the PEF (forced expiratory peak flow) of SIT group was higher than that of the control group (t=2.07～3.59, Plt;0.05). and FEV1 between the two groups had no significant difference (Pgt;0.05), The asthma symptom score of SIT group obviously increased the next year (t=4.59～7.36, Plt;0.01) and no serious adverse reaction was observed.Conclusions: The dust mite allergens standardization of SIT can significantly reduce the dose of inhaled steroid, improve lung function, improve clinical symptom score and is secure. ［Key words］ Asthma; children; Specific immunotherapy; Standardization of the allergen; Lung function 特异性免疫治疗（specific immunotherapy，SIT）为儿童支气管哮喘唯一的对因治疗方法，其疗效与过敏原的准确量化有直接关系。我们于2004年11月～2007年12月对53例支气管哮喘儿童采用屋尘螨及粉尘螨标准化变应原进行特异性免疫治疗，现总结如下： 1 资料与方法 1.1 研究对象 全部病例均来自于2004年11月～ 2007年12月我院儿科门诊。SIT组53例，其中男30例，女23例，平均年龄（7.4±2.1）岁，病程1